ABSTRACT
La principal responsabilidad del anestesiólogo es asegurar la función respiratoria del paciente que ha de someterse a una intervención quirúrgica o que precisa la aplicación de técnicas de reanimación ante amenazas vitales. Entre las múltiples opciones para asegurar y mantener permeable la vía aérea se encuentra la cricotirotomía, casi siempre como última alternativa pero definitiva para asegurar la supervivencia del paciente que es imposible de ventilar o intubar por otros medios. Existen diferentes técnicas para la cricotirotomía: con catéter, punción-dilatación, o quirúrgica, y pueden hacerse combinaciones, como sería en el caso de utilizar una guía que dirija el tubo a la tráquea con la técnica quirúrgica (AU)
The anesthesiologist's chief responsibility is to ensure ventilation of the patient who is undergoing surgery or to apply resuscitation measures in life-threatening situations. Cricothyrotomy is one among many options available for maintaining airway patency. Usually it is the last resort but can be a lifesaving maneuver in the cannot-intubate, cannot-ventilate patient. The various types include cannula insertion, percutaneous puncture and dilatation, and surgical cricothyrotomy; techniques may be combined, as in the case of surgically inserting a cannula over a trocar (AU)
Subject(s)
Female , Humans , Male , Anesthesiology , Anesthesiology/organization & administration , Respiratory System , Catheter Ablation/methods , Catheters , Cardiopulmonary Resuscitation/methods , Cardiopulmonary Resuscitation/trends , Cardiopulmonary ResuscitationSubject(s)
Ventilators, Mechanical , Aged , Bronchi , Equipment Design , Female , Humans , Male , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Tidal Volume , Pulmonary Ventilation , Bronchoscopy/trends , Bronchoscopy , Anesthesia , Ventilation/methods , Thoracic Surgery/methods , Sympathectomy/methodsABSTRACT
The anesthesiologist's chief responsibility is to ensure ventilation of the patient who is undergoing surgery or to apply resuscitation measures in life-threatening situations. Cricothyrotomy is one among many options available for maintaining airway patency. Usually it is the last resort but can be a lifesaving maneuver in the cannot-intubate, cannot-ventilate patient. The various types include cannula insertion, percutaneous puncture and dilatation, and surgical cricothyrotomy; techniques may be combined, as in the case of surgically inserting a cannula over a trocar.
Subject(s)
Airway Management/methods , Cricoid Cartilage/surgery , Intubation, Intratracheal/methods , Thyroid Cartilage/surgery , Equipment Design , Humans , Intubation, Intratracheal/instrumentationSubject(s)
Algorithms , Ambulatory Surgical Procedures , Intubation, Intratracheal/methods , Adult , Decision Trees , Glottis , HumansABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Ambulatory Surgical Procedures/instrumentation , Ambulatory Surgical Procedures/methods , Respiratory Protective Devices/classification , Respiratory Protective Devices , Ambulatory Care/methods , Ambulatory Care/trends , Ambulatory Surgical Procedures/trends , Ambulatory Surgical ProceduresABSTRACT
Helium is a noble gas whose low density decreases airway resistance. This property is utilized when a mixture of helium and oxygen (heliox) is employed in certain clinical situations, particularly in the context of airway obstruction. We report the case of a woman with severe upper airway obstruction due to bilateral vocal cord paralysis after thyroidectomy. Heliox was used temporarily to reduce respiratory effort and avoid the need for tracheal intubation while the obstruction was being treated with antiinflammatory drugs.
Subject(s)
Airway Obstruction/drug therapy , Helium/therapeutic use , Oxygen Inhalation Therapy , Oxygen/therapeutic use , Postoperative Complications/drug therapy , Thyroidectomy , Vocal Cord Paralysis/etiology , Work of Breathing/drug effects , Airway Obstruction/etiology , Anti-Inflammatory Agents/therapeutic use , Deep Brain Stimulation , Dexamethasone/therapeutic use , Dyspnea/etiology , Emergencies , Female , Helium/pharmacology , Humans , Laryngeal Edema/drug therapy , Laryngeal Edema/etiology , Middle Aged , Oxygen/pharmacology , Parkinson Disease/complications , Parkinson Disease/therapy , Postoperative Complications/etiology , Vocal Cord Paralysis/drug therapyABSTRACT
El helio es un gas noble que por su baja densidad disminuyela resistencia de la vía aérea. Esta propiedad,empleando una mezcla de helio y oxígeno (heliox), permiteque sea útil en determinadas situaciones clínicas,especialmente en las obstrucciones de vía aérea. Describimosel caso de una paciente que presentó un cuadro deobstrucción grave de la vía aérea superior debido a laparálisis bilateral de cuerdas vocales después de unatiroidectomía. El heliox se usó temporalmente para disminuirel esfuerzo respiratorio y evitar la intubaciónendotraqueal mientras mejoraba la obstrucción conantiinflamatorios(AU)
Helium is a noble gas whose low density decreasesairway resistance. This property is utilized when amixture of helium and oxygen (heliox) is employed incertain clinical situations, particularly in the context ofairway obstruction. We report the case of a woman withsevere upper airway obstruction due to bilateral vocalcord paralysis after thyroidectomy. Heliox was usedtemporarily to reduce respiratory effort and avoid theneed for tracheal intubation while the obstruction wasbeing treated with antiinflammatory drugs(AU)
Subject(s)
Humans , Female , Middle Aged , Airway Obstruction/drug therapy , Helium/therapeutic use , Oxygen/therapeutic use , Airway Obstruction/etiology , Oxygen Inhalation Therapy , Postoperative Complications/drug therapy , Thyroidectomy , Vocal Cord Paralysis/etiology , Work of Breathing , Anti-Inflammatory Agents/therapeutic use , Dexamethasone/therapeutic use , Dyspnea/etiology , Helium/pharmacology , Laryngeal Edema/drug therapy , Laryngeal Edema/etiology , Oxygen/pharmacology , Parkinson Disease/complications , Postoperative Complications/etiology , Vocal Cord Paralysis/drug therapyABSTRACT
We report a case of diagnostic thoracoscopy of a right lobe in a patient with left upper lobe atelectasis due to invasion by a bronchial tumor. We anticipated difficulty in maintaining the desired oxygenation while using the conventional strategy of collapsing the whole operated lung and ventilating only the opposite one. The solution was to apply continuous positive airway pressure to 2 right lobes while only collapsing the lobe to be biopsied.
Subject(s)
Continuous Positive Airway Pressure , Lung Neoplasms/surgery , Thoracoscopy , Biopsy , Female , Humans , Lung Neoplasms/pathology , Middle Aged , Pneumonectomy/methodsABSTRACT
Comunicamos un caso de toracoscopía diagnóstica derecha en una paciente con atelectasia del lóbulo superior izquierdo secundaria a la invasión tumoral del bronquio. Por ello se anticipó que habría dificultades para mantener la oxigenación deseada con una técnica convencional de aislamiento pulmonar, en la que sólo se ventilase el pulmón izquierdo. La solución adoptada consistió en aplicar CPAP a dos lóbulos derechos, mientras se mantenía colapsado el lóbulo que se iba a biopsiar
We report a case of diagnostic thoracoscopy of a right lobe in a patient with left upper lobe atelectasis due to invasion by a bronchial tumor. We anticipated difficulty in maintaining the desired oxygenation while using the conventional strategy of collapsing the whole operated lung and ventilating only the opposite one. The solution was to apply continuous positive airway pressure to 2 right lobes while only collapsing the lobe to be biopsied
